Provider Demographics
NPI:1538406814
Name:STRONG, WILSON WILLARD JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILSON
Middle Name:WILLARD
Last Name:STRONG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2023 KEYSTONE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:KEYSTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80435-8386
Mailing Address - Country:US
Mailing Address - Phone:970-513-1338
Mailing Address - Fax:970-513-1338
Practice Address - Street 1:2023 KEYSTONE RANCH RD
Practice Address - Street 2:
Practice Address - City:KEYSTONE
Practice Address - State:CO
Practice Address - Zip Code:80435-8386
Practice Address - Country:US
Practice Address - Phone:970-513-1338
Practice Address - Fax:970-513-1338
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
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Provider Licenses
StateLicense IDTaxonomies
CO38430208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)